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Amend HB 2292, on third reading, by striking page 81, line 22 
through page 83, line 17 and substituting the following and 
relettering accordingly:
	(c)  For purposes of this section, the term "supplemental 
rebates" shall mean cash rebates paid by a pharmaceutical 
manufacturer to the State on the basis of quarterly Medicaid 
utilization data relating to such manufacturer's products, 
pursuant to a State supplemental rebate agreement negotiated with 
such manufacturer and approved by the federal government under 
Section 1927 of the federal Social Security Act.
	(d)  The commission may enter into a written agreement with a 
manufacturer to accept certain program benefits in lieu of 
supplemental rebates, as such term is defined herein, only if:
		(1)  the program benefit yields savings that are at 
least equal to the amount the manufacturer would have provided 
under a state supplemental rebate agreement during the current 
biennium as determined by such written agreement;
		(2)  the manufacturer posts a performance bond 
guaranteeing savings to the state.  If the savings are not achieved 
in accordance with the written agreement, the manufacturer will 
forfeit the bond to the state less any savings that were achieved; 
		(3)  the program benefit is in addition to other program 
benefits currently offered by the manufacturer to recipients of 
medical assistance or related programs.
	(e)  For the purposes of this section, a program benefit may 
mean disease management programs authorized under this title, drug 
product donation programs, drug utilization control programs, 
prescriber and beneficiary counseling and education, fraud and 
abuse initiatives, and other services or administrative 
investments with guaranteed savings to a program operated by a 
health and human service agency.
	(f)  Other than as required to satisfy the provisions of this 
section, such program investments shall be deemed an alternative 
to, and not the equivalent of, supplemental rebates and shall be 
treated in the State's submissions to the federal government 
(including, as appropriate, waiver requests and quarterly Medicaid 
claims) so as to maximize the availability of federal matching 
	(g)  Agreements by the commission to accept program benefits 
as defined by this section:
		(1)  may not prohibit the commission from entering into 
similar agreements related to different drug classes with other 
		(2)  shall be limited to a time period expressly 
determined by the commission; and
		(3)  may only cover products that have received approval 
by the Federal Drug Administration at the time of the agreement, and 
new products approved after the agreement may be incorporated only 
under an amendment to the agreement.
	(h)  For the purposes of this section, the commission may 
consider a monetary contribution or donation to the arrangements 
described in subsection (b) for the purpose of offsetting 
expenditures to other state healthcare programs, but which funding 
shall not be used to offset expenditures for covered outpatient 
drugs as defined by 42 USC Section 1396(k)(5) under the vendor drug 
program.  An arrangement under this subsection may not yield less 
than the amount the state would have benefitted under a 
supplemental rebate.  The commission may consider an arrangement 
under this section as satisfying the requirements related to 
Section 531.072(b)."